When Administration Stifles Clinical Care: The Real Cost of Bureaucratic Burden in Pharmacy

4 mai 2026pharmia
Actuality
When Administration Stifles Clinical Care: The Real Cost of Bureaucratic Burden in Pharmacy

Quebec pharmacists lose hundreds of hours every year to administrative tasks. Meanwhile, patients wait — and the healthcare system runs out of breath.

A clinical activity in full expansion

In 2023, Quebec’s community pharmacies delivered more than 7 million clinical acts — a 16% increase in a single year. Since 2019, that’s a 51% growth in clinical activity. Quebec pharmacists have become, de facto, the first point of contact in the healthcare network: accessible without an appointment, seven days a week, in more than 1,900 pharmacies across the province.

But this clinical growth has happened without the resources to support it.

The shortage that amplifies everything

Quebec is short roughly 1,150 pharmacists. The vacancy rate in community pharmacy reaches 12%, four times the provincial average across all sectors. In 2024, one million replacement hours were needed just to maintain basic service.

And a significant share of those hours never even reaches the patient.

The daily reality behind the counter

The typical day of a community pharmacist in 2026 isn’t only clinical work. It’s also:

  • Answering calls from other pharmacies and physicians to clarify prescriptions, confirm therapies, or coordinate file transfers.
  • Documenting every clinical intervention in often outdated systems, then faxing — yes, faxing, in 2026 — follow-ups to prescribers.
  • Verifying, before each act, whether it complies with the regulatory framework in force: laws, regulations, agreements, exceptions.
  • Filling out administrative forms that have no clinical value but are required by the system.
  • Calling patients back for follow-ups the system doesn’t handle automatically.

These tasks are necessary in principle, but their execution remains largely manual, fragmented, and time-consuming.

The numbers tell the story

In Quebec

According to the 2024 survey of its members by the APPSQ (Quebec’s professional association of salaried pharmacists), most salaried pharmacists report a workload that is still far too heavy and conditions that are poorly suited to clinical practice. Even more revealing: 65% of respondents fear that the new acts introduced by Bill 67 will worsen this overload if no concrete administrative relief accompanies the expanded scope of practice.

The AQPP (Quebec association of pharmacy owners) sounded the alarm as early as March 2024, publicly calling for the removal of certain administrative rules surrounding clinical activities. The message was clear: rules designed to frame practice end up restricting patients’ access to care. AQPP president Benoit Morin summed it up this way: the barriers must come down so that the 7,000 pharmacists in the network can serve their patients effectively.

Across Canada

The Quebec picture fits within a documented national trend. The Canadian Medical Association (CMA) estimates that Canadian healthcare professionals collectively lose 18.5 million hours per year on unnecessary administrative tasks — the equivalent of 55.6 million patient visits. And according to the CMA, 85% of that work comes from the healthcare system’s own processes, not from the clinical complexity of the cases.

For pharmacists specifically, data from the Canadian Pharmacists Association (CPhA) reveals a direct link between administrative burden and burnout: pharmacists experiencing burnout spend an average of 7.5 hours per week on administrative tasks, compared to 4.3 hours for those who aren’t. In 2023, 79% of pharmacy professionals in Canada were at risk of burnout.

Internationally

The phenomenon isn’t unique to Canada. In the United States, recent studies report that pharmacists can spend up to 90% of their time on administrative tasks rather than direct patient care. Pharmacy staff burnout has reached historic levels there, largely attributed to workload and chronic understaffing.

Bill 67: a major step forward, but incomplete

Adopted by the National Assembly, Bill 67 represents a historic reform of Quebec’s pharmacy legal framework. It promises to substantially expand pharmacists’ professional autonomy:

  • Prescribing medication with fewer restrictions
  • Extending prescriptions without arbitrary deadlines
  • Substituting medications in more clinical situations
  • Replacing certain administrative rules with the pharmacist’s professional judgment

The Ordre des pharmaciens du Québec (OPQ) hailed the reform as “a historic step for access to care.” The draft regulation was published in the Gazette officielle in June 2025 for public consultation, with updates in October 2025.

But adopting the law doesn’t solve everything. The APPSQ underlined this in its November 2025 statement: current working conditions in community pharmacy still cannot absorb the new responsibilities introduced by Bill 67. Without concrete relief from the administrative burden, expanding the scope of practice amounts to adding more weight onto already overloaded shoulders.

La Presse reported in December 2025 that the expansion of pharmacists’ powers was slow to materialize in practice, despite the law’s adoption.

The real problem: systems built for another era

The administrative burden in pharmacy is no accident. It’s the result of systems designed decades ago, when the pharmacist’s role was essentially limited to dispensing medication. These systems — pharmacy software, prescriber communication processes, billing mechanisms, documentation protocols — haven’t evolved at the same pace as the practice.

The result is a structural mismatch:

  • Fragmented inter-professional communication: fax remains the dominant communication mode between pharmacies and prescribers in most practice settings.
  • Redundant documentation: a single clinical act can require documentation in the pharmacy software, a paper form, a fax to the prescriber, and a chart note.
  • Manual regulatory verification: before each expanded act, the pharmacist must mentally (or physically) review the applicable regulatory framework — laws, regulations, AQPP-MSSS agreements, collective prescriptions — to confirm the act is permitted.
  • Complex billing: the billing system for clinical acts, governed by the AQPP-MSSS agreement, includes dozens of codes, conditions, and exceptions that vary by act type, patient status, and clinical situation.

What technology can change — and what it can’t

Technological solutions exist, and some are already deployed in other jurisdictions or other healthcare sectors. Among the most promising avenues:

Automated clinical documentation

Artificial intelligence can now capture, structure, and write clinical documentation from a conversation between the professional and the patient. Platforms like Abridge (which reached $100M in annual revenue automatically documenting medical consultations) show that the technology is mature. The same principles apply in pharmacy: capture the clinical exchange, generate the note, the follow-up, and the prescriber communications — automatically.

Intelligent regulatory verification

Instead of forcing the pharmacist to manually consult the legal framework before each act, a smart tool can cross-reference the clinical situation with the current regulations and confirm compliance instantly. That’s the “compliance by design” approach: the system checks for you, in real time.

Information system integration

Communication between pharmacies, prescribers, and healthcare facilities should be digital, bidirectional, and instant. The Dossier Santé Québec (DSQ) is a step in that direction, but its integration into daily workflows remains incomplete.

Billing automation

Billing for clinical acts can be automatically derived from the documented act, eliminating double entry and coding errors.

What technology doesn’t replace

The pharmacist’s clinical judgment. The trust relationship with the patient. The assessment of a complex situation that requires experience and context. Technology isn’t there to replace the pharmacist — it’s there to give back the time to do what they were trained for.

The real issue: time

Every hour spent filling out a form, faxing a document, or manually checking a regulatory framework is one less hour at the counter with a patient. In a labour shortage context, every hour counts.

The question isn’t whether pharmacists can do more. They are already doing more, every year, with fewer people. The question is how much longer we keep wasting time on processes that could be automated — and how many patients miss out on care that could have been provided if the pharmacist had had five more minutes.

Bill 67 gives pharmacists new powers. It’s time to give them the tools to exercise them.


Pharmia builds artificial intelligence tools designed specifically for Quebec pharmacists — automated clinical documentation, real-time regulatory verification, and instant access to the entire normative framework of pharmacy practice in Quebec.


References

  1. AQPP — “Pharmacy owners call for the removal of certain administrative rules” (March 2024)
    monpharmacien.ca
  2. La Presse — “Pharmacy owners call for the removal of certain administrative rules” (March 2024)
    lapresse.ca
  3. APPSQ — 2024 survey on irritants in community pharmacy
    appsq.org
  4. APPSQ — Statement on Bill 67 (November 2025)
    appsq.org
  5. Canadian Medical Association (CMA) — Administrative burden: facts and figures
    cma.ca
  6. Canadian Pharmacists Association (CPhA) — National survey on the mental health of pharmacy professionals (2023)
    pharmacists.ca
  7. Ordre des pharmaciens du Québec (OPQ) — “Bill 67 adopted: a historic step for access to care”
    opq.org
  8. OPQ — “Bill 67 adopted: fewer administrative barriers, more autonomy”
    opq.org
  9. La Presse — “Expansion of pharmacists’ powers slow to be implemented” (December 2025)
    lapresse.ca
  10. OPQ — Bill 67 draft regulation, Gazette officielle (June 2025)
    opq.org
  11. Profession Santé — “Pharmacy irritants: APPSQ unveils its survey” (August 2024)
    professionsante.ca
  12. Portail de l’assurance — “Pharmacists play a growing role in primary care” (April 2026)
    portail-assurance.ca
  13. Sully.ai — “Top 3 AI Pharmacists in 2026”
    sully.ai
  14. MedMe Health — “An Overview of AI in Pharmacy” (2025)
    medmehealth.com
  15. Contrary Research — “Abridge Business Breakdown”
    research.contrary.com